Cancer of the EsophagusPhase 1/2POXXNCT00578071
Phase I/II Study of Panitumumab, Capecitabine and Oxaliplatin w EBRT for Esophageal Cancer
A Phase 1/2 study testing Panitumumab, Capecitabine and Oxaliplatin in people with Cancer of the Esophagus, run by Brian Czito at 1 site in United States.
Trial summary
The primary purpose of this trial is to define the maximum tolerated and/or recommended phase II dose of the combination of panitumumab, oxaliplatin and capecitabine in patients undergoing radiation therapy for carcinoma of the thoracic esophagus or gastroesophageal junction. Read more about this study
- Who is it for?
- Ages 18 to 82 years
- Conditions the study is for
- Cancer of the Esophagus
- What is being tested?
- Panitumumab, Capecitabine and Oxaliplatin
- Type of treatment
- Pill or oral medicine, Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 29 participants
- Where
- 1 siteUnited States
- Study dates
- Dec 2007to Jun 2012
- Phase
- Phase 1/2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 82 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- 18 years of age or older.
- Histologically or cytologically documented squamous cell carcinoma or Siewert's classification adenocarcinoma of the esophagus or proximal stomach T1-4, N0-2, M0-1, for which bimodality treatment with chemotherapy and radiation therapy is indicated.
- Measurable Disease
- ECOG Performance Status 0-1
- Laboratory values must be as follows:
- Absolute neutrophil count > or = 2,000/mm3,
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- Platelets > or = 100,000/mm3,
- Hemoglobin > 9.0,
- Total bilirubin <1.5 x institutional upper normal limit,
- Serum creatinine <1.5 x institutional upper normal limit,
- AST or ALT < 3x institutional upper normal limit,
- Magnesium equal or higher than institutional lower limit,
- Creatinine clearance Estimated > 40 ml/min,
- Calcium > lower limit of normal.
- Not pregnant or lactating. Negative pregnancy test within 72 hours prior to registration (female patients of childbearing potential). Postmenopausal woman must have been amenorrheic for at least 12 months to be considered of non-childbearing potential.
- Life expectancy must be >3 months.
- No serious or poorly controlled medical or psychological conditions that could be exacerbated by the treatment or would seriously complicate compliance with the protocol.
- Able to swallow capecitabine (whole or crushed tablet or liquid dispersed) or patients may have a G or J tube.
- No conditions that would significantly compromise intestinal absorption of the study drugs.
Who cannot join
- Tumors extending above the level of the thoracic inlet or beyond 5 cm below the gastroesophageal junction.
- Patients with radiographic or bronchoscopic evidence of esophageal perforation.
- Patients with known evidence of brain metastases, lymphangitic lung metastases, or carcinomatous meningitis.
- Dementia or significantly altered mental status
- Major surgery within 4 weeks of the start of study treatment
- Prior chemotherapy, radiation therapy, hormonal or biologic therapy within the past 6 months.
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- Subjects requiring chronic use of immunosuppressive agents (e.g., methotrexate, cyclosporine, corticosteroids)
- Currently requiring medications that may interact with the metabolism or disposition of capecitabine/5-FU: dipyridamole, folinic acid, allopurinol, trimethoprim, misonidazole, metoclopramide, flucytosine or cimetidine.
- Hypersensitivity to platinum containing compounds or capecitabine or any of the excipients of this product. Prior unanticipated severe reaction to fluoropyrimidine/platinum therapy, or known sensitivity to 5-fluorouracil/platinum containing compounds.
- Serious, uncontrolled, concurrent infection(s).
- History of other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that might affect the interpretation of the results of the study or render the subject at high risk from treatment complications.
- Treatment for other carcinomas within the last five years, except cured non-melanoma skin and treated in-situ cervical cancer.
- Peripheral neuropathy > grade 1
- Any of the following within 24 weeks before randomization: clinically significant cardiovascular disease (including myocardial infarction, unstable angina, symptomatic congestive heart failure, serious uncontrolled cardiac arrhythmia).
- Uncontrolled gastrointestinal ulcer within 28 days of randomization
- History of interstitial pneumonitis or pulmonary fibrosis, or evidence of interstitial pneumonitis or pulmonary fibrosis on baseline chest X-ray or CT-scan
- Preexisting known bleeding diathesis or coagulopathy
- Plans to continue on or use of ketoconazole, phenytoin, phenobarbital, carbamazepine, rifampin, rifabutin or St. John's Wort, 14 days prior to randomization.
- History of hypersensitivity to tetracyclines
- Subject known to be human immunodeficiency virus positive
- Subjects known to have chronic or active hepatitis B or C infection
Trial locations and contacts
1 site in 1 country.
United States1 site
Duke University Medical Center
Durham, North Carolina, 27710
About this study
Official title: A Phase I/II Study of Panitumumab, Capecitabine and Oxaliplatin Chemotherapy With External Beam Radiation Therapy for the Treatment of Resectable, Locally Advanced/Unresectable or Metastatic Esophageal Cancer
The primary purpose of this trial is to define the maximum tolerated and/or recommended phase II dose of the combination of panitumumab, oxaliplatin and capecitabine in patients undergoing radiation therapy for carcinoma of the thoracic esophagus or gastroesophageal junction. An additional primary objective is to describe the frequency and nature of grade III/IV and grade I/II toxicities associated with this regimen. Secondary objectives include describing 1-year disease-free survival and overall survival rates as well as to estimate clinical and pathologic complete response rates associated with this regimen.
Read the detailed description
This study has a phase I/II design. For this study the administration of panitumumab is considered investigational.
Pretreatment: Part of regular cancer care and disease staging includes Chest/Abdomen CT Scan, upper endoscopic ultrasound, PET scan, J-Tube Placement (if clinically indicated), bronchoscopy (per clinician judgment), ECG, and baseline laboratory studies.
During Treatment Weeks 1-5.5 of Radiation Therapy(RT)/Chemotherapy:
- RT (180 cGy/fx, Mon-Fri) days 1-5, 8-12, 15-19, 22-26, 29-33 and 36-38.
- Panitumumab (per dose level) days 1, 15, 29.
- Oxaliplatin (per dose level) days 1, 8, 15, 22, 29, 36.
- Capecitabine (per dose level M-F) 1-5, 8-12, 15-19, 22-26, 29-33, 36-38.
- Conditions
- Cancer of the Esophagus
- Being tested
- Panitumumab, Capecitabine, Oxaliplatin, Radiation Therapy (RT)
- Keywords
- esophageal cancer
- Medical subject headings
- Esophageal Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PanitumumabDrug
Dose per cohort level (3.6, 4.8 or 6.0 mg/kg ), given intravenously (IV) days 1, 15 and 29 of radiation.
CapecitabineDrug
Also called Xeloda
Dose per cohort level (500, 625 or 825 mg/m2) taken by mouth twice each day of radiation
OxaliplatinDrug
Dose per cohort level (30, 40, or 50 mg/m2). Given IV one day each week during radiation
Radiation Therapy (RT)Radiation
Daily for 6 weeks
| Study group | Role | What they receive |
|---|---|---|
| Treatment | Experimental | panitumumab, oxaliplatin, capecitabine and EBRT Receives: Drug: Panitumumab; Drug: Capecitabine; Drug: Oxaliplatin; Radiation: Radiation Therapy (RT) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Panitumumab Maximum Tolerated Dose in Milligrams (mg)
Measured: 60 days
Number of Participants With Dose-limiting Toxicities (DLTs)
Measured: Within 30 days of the last day of radiation
Secondary outcomes (2)
Overall Survival Rates for the Patients Studied on This Protocol.
Number of patients alive one year after completing study protocol treatment.
Measured: One year
Pathological Complete Response Rates Associated With This Regimen.
Absence of residual viable tumor cells at the time of surgical resection of the esophagus performed 7-9 weeks following completion of chemoradiotherapy.
Measured: 90 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Dec 2007 (estimated)
- Study startDec 2007
- Primary completionJul 2011
- Study completionJun 2012
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Cancer of the EsophagusStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 1/2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 29 participants (actual)
Sponsor and investigators
- Lead sponsor
- Brian Czito
- Sponsor type
- University, hospital or other
- Collaborators
- Amgen
- Responsible party
- Sponsor-investigator, Brian Czito, Duke University
- Investigators
- Brian Czito, MD, Principal investigator, Duke University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00578071
- Sponsor's protocol ID
- Pro00002207
- Other IDs
- SPS 151596
- Acronym
- POXX
- Status last verified
- May 2015
- First submitted
- 18 Dec 2007
- Last updated
- 2 Jul 2015
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 2 Jul 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase I/II Study of Panitumumab, Capecitabine and Oxaliplatin Chemotherapy With External Beam Radiation Therapy for the Treatment of Resectable, Locally Advanced/Unresectable or Metastatic Esophageal Cancer
- ClinicalTrials.gov ID
- NCT00578071
- Acronym / sponsor ID
- POXX / Pro00002207
- Conditions
- Cancer of the Esophagus
- Keywords
- esophageal cancer
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 29 participants (actual)
- Lead sponsor
- Brian CzitoUniversity, hospital or other
- Collaborators
- Amgen
- Study start
- Dec 2007
- Primary completion
- Jul 2011 (actual)
- Study completion
- Jun 2012 (actual)
- First posted
- 20 Dec 2007 (estimated)
- Results
- Posted 7 Aug 2012
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary purpose of this trial is to define the maximum tolerated and/or recommended phase II dose of the combination of panitumumab, oxaliplatin and capecitabine in patients undergoing radiation therapy for carcinoma of the thoracic esophagus or gastroesophageal junction. An additional primary objective is to describe the frequency and nature of grade III/IV and grade I/II toxicities associated with this regimen. Secondary objectives include describing 1-year disease-free survival and overall survival rates as well as to estimate clinical and pathologic complete response rates associated with this regimen.
Detailed description
This study has a phase I/II design. For this study the administration of panitumumab is considered investigational.
Pretreatment: Part of regular cancer care and disease staging includes Chest/Abdomen CT Scan, upper endoscopic ultrasound, PET scan, J-Tube Placement (if clinically indicated), bronchoscopy (per clinician judgment), ECG, and baseline laboratory studies.
During Treatment Weeks 1-5.5 of Radiation Therapy(RT)/Chemotherapy:
- RT (180 cGy/fx, Mon-Fri) days 1-5, 8-12, 15-19, 22-26, 29-33 and 36-38.
- Panitumumab (per dose level) days 1, 15, 29.
- Oxaliplatin (per dose level) days 1, 8, 15, 22, 29, 36.
- Capecitabine (per dose level M-F) 1-5, 8-12, 15-19, 22-26, 29-33, 36-38.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Treatment | Experimental | Drug: Panitumumab, Drug: Capecitabine, Drug: Oxaliplatin, Radiation: Radiation Therapy (RT)panitumumab, oxaliplatin, capecitabine and EBRT |
Who may qualify
- Ages
- 18 to 82 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (19 listed)
- 18 years of age or older.
- Histologically or cytologically documented squamous cell carcinoma or Siewert's classification adenocarcinoma of the esophagus or proximal stomach T1-4, N0-2, M0-1, for which bimodality treatment with chemotherapy and radiation therapy is indicated.
- Measurable Disease
- ECOG Performance Status 0-1
- Laboratory values must be as follows:
Key exclusion criteria (21 listed)
- Tumors extending above the level of the thoracic inlet or beyond 5 cm below the gastroesophageal junction.
- Patients with radiographic or bronchoscopic evidence of esophageal perforation.
- Patients with known evidence of brain metastases, lymphangitic lung metastases, or carcinomatous meningitis.
- Dementia or significantly altered mental status
- Major surgery within 4 weeks of the start of study treatment
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| PanitumumabDose per cohort level (3.6, 4.8 or 6.0 mg/kg ), given intravenously (IV) days 1, 15 and 29 of radiation. | Drug | Treatment |
| CapecitabineAlso: XelodaDose per cohort level (500, 625 or 825 mg/m2) taken by mouth twice each day of radiation | Drug | Treatment |
| OxaliplatinDose per cohort level (30, 40, or 50 mg/m2). Given IV one day each week during radiation | Drug | Treatment |
| Radiation Therapy (RT)Daily for 6 weeks | Radiation | Treatment |
Primary outcome
Panitumumab Maximum Tolerated Dose in Milligrams (mg)
Time frame: 60 days
Number of Participants With Dose-limiting Toxicities (DLTs)
Time frame: Within 30 days of the last day of radiation
2 secondary outcomes
Overall Survival Rates for the Patients Studied on This Protocol.
Time frame: One year
Pathological Complete Response Rates Associated With This Regimen.
Time frame: 90 days
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Jul 2015.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Clinical Trials at Duke Comprehensive Cancer CenterLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Brian Czito, MD principal investigator
Duke University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing Panitumumab, Capecitabine and Oxaliplatin in people with Cancer of the Esophagus, run by Brian Czito at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 19 inclusion and 21 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 2 Jul 2015. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this combined phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 7 Aug 2012). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Panitumumab Maximum Tolerated Dose in Milligrams (mg) (time frame: 60 days). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Jul 2015.